PLUMBING PERMITPermit No
Amount of Permit $
7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. , !�
Owner's Name and Address Z,_.
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot___ _..____:
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING '1.oNIT
Street and Number where work is to be performed —No
i % ,
E
State work to be performed and purpose of building (By Floors)
New Building _ Remodeling_____ _____ Addition_
No.__ f - •--- -______ Street
Block
(Signed) _
No._ _7/1
Street__
Subdivision _._.
Street 4 e 7/ G4
Repairs No. of Stories.
Size Septic Tank, ___ Type of Tank__ Capacity Gals
Feet of Drain :___Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well ______Size of Soakage Pit
Date (�� U
f
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts I is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed ) /7.— —47 _id
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. 1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
S
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
URINALS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWI PA' G
POOL
CONTR.
LIST
CHECK
Permit No
Amount of Permit $
7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. , !�
Owner's Name and Address Z,_.
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot___ _..____:
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING '1.oNIT
Street and Number where work is to be performed —No
i % ,
E
State work to be performed and purpose of building (By Floors)
New Building _ Remodeling_____ _____ Addition_
No.__ f - •--- -______ Street
Block
(Signed) _
No._ _7/1
Street__
Subdivision _._.
Street 4 e 7/ G4
Repairs No. of Stories.
Size Septic Tank, ___ Type of Tank__ Capacity Gals
Feet of Drain :___Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well ______Size of Soakage Pit
Date (�� U
f
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts I is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed ) /7.— —47 _id
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. 1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of r
Building 1
® ❑ DATE A` ` 195 '
PERMIT N? 7223 Contractor's
License No.
0
❑ Work to be performed under this Permit
Architect
Contractor
or Builder 1' .
Legal Lot
Description — � Bl.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed-
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
Subdi-
vision
Value of 11 Amount of
Project $ 1 Permit $
BY:
BY AUTHORITY
Permit No. - S i'
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or (Abel
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Amount of Permit S.
Registered Architect and /or Engineer____.
Employing Plumber's Name..____
Nature of Water Supply: City -Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
(lc?). , : _ _ No Street
Location and Legal Description Loi-_--__------ .......... _- ..... - _- _____.._ _Block __ -- . _. _______ -- - Subdivision
-------- -___ --
Street and Number where work is to be performed -No e
State work to be performed and purpose of building (By Floors)
New Building _ Remodeling Addition__
Size Septic Tank Type of Tank___ Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
No . _ ._ - - _ Street
Repairs__
Size of Soakage Pit
,\ ('"; --
_ (Signed) ______
Plumbing Inspector.
The undersigned appli• : nt for this building permit does hereby certify that he understands ad accepts his obligations as an employer of labor
under the Florida Wor . n's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanent Supplement, and has co n-
plied with the provision thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on ork to erformed under this _hermit, as are
licensed by Miami Shores Village. ` ✓ ., q ° � "
/ifi!�o %; /J��, %,
(Signed)._ == - - -- - -
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac
therein by him stated are true.
My Conunission Expires Notary Public, State of Florida
No. of Stories
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Lill
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWER6
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIKTUREI
CONTR.
LIST
CHECK
-
-
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'C
POOL
CONTR.
LIST
CHECK
Permit No. - S i'
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or (Abel
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Amount of Permit S.
Registered Architect and /or Engineer____.
Employing Plumber's Name..____
Nature of Water Supply: City -Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
(lc?). , : _ _ No Street
Location and Legal Description Loi-_--__------ .......... _- ..... - _- _____.._ _Block __ -- . _. _______ -- - Subdivision
-------- -___ --
Street and Number where work is to be performed -No e
State work to be performed and purpose of building (By Floors)
New Building _ Remodeling Addition__
Size Septic Tank Type of Tank___ Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
No . _ ._ - - _ Street
Repairs__
Size of Soakage Pit
,\ ('"; --
_ (Signed) ______
Plumbing Inspector.
The undersigned appli• : nt for this building permit does hereby certify that he understands ad accepts his obligations as an employer of labor
under the Florida Wor . n's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanent Supplement, and has co n-
plied with the provision thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on ork to erformed under this _hermit, as are
licensed by Miami Shores Village. ` ✓ ., q ° � "
/ifi!�o %; /J��, %,
(Signed)._ == - - -- - -
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac
therein by him stated are true.
My Conunission Expires Notary Public, State of Florida
No. of Stories
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Lill
materials and /or workmanship.
BUILDING ❑
ELECTRICAL ❑ PERMIT N9
PLUMBING
ROOFING
Owner of
Building
MIAMI SHORES
❑ Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot II B1.
Description
Address of
Building F
VILLAGE, FLORIDA
14616
Subdi-
vision
Value of
Project
CONTRACTOR OR BUILDER BY
DATE
$ ..� , ..4.0..,..ti
195
Contractor's
License No.
Arat. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
J
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of "'° .,
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
DATE l
PERMIT N° 9461
t�
Work to he performed under this Permit
1 j
CTOR OR BUILDER
Bl.
i{
Subdi-
vision
Value of
Project $
Cozstz zctor s
License No
Amt. of
Permit
$ /
195
This permit is granted to the contiactur or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the state}nents or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed f { BY • '71--
INSPECTOR
In consideration of the issuance to me of this permit I agree 45 erform the work covered hereunder in compliance with? all / rdinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
Ia accep this pe� responsibility for all work done by eithe myself, my age servant o oyee.
AUTHORITY
Permit No. ' , ( Date_ f °�
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith .kubmitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address it
Registered Architect and /or Engineer
Employing Plumber's Name / No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No . =b' Street r
State work to be performed end purpose of building (By Floors)
New Building ` Remodeling Addition Repairs No. of Stories____________
Amount of Permit $
L
ss.
a r
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank
No - Street -
Capacity Gals.
Size Septic Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City-,Well Size of Soakage Pit
f
( Signed) a
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
i
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
f ` .
f � [ / y !' iFi
- -�,-/-
,
TOTAL
FIXTURES
FIXTURES
CONTR.
LIST
f
CHECK
//
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
-R
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G.
POOL
II /
W 4 [
CONTR.
LIST
,/
7 /
2
CHECK
Permit No. ' , ( Date_ f °�
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith .kubmitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address it
Registered Architect and /or Engineer
Employing Plumber's Name / No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No . =b' Street r
State work to be performed end purpose of building (By Floors)
New Building ` Remodeling Addition Repairs No. of Stories____________
Amount of Permit $
L
ss.
a r
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank
No - Street -
Capacity Gals.
Size Septic Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City-,Well Size of Soakage Pit
f
( Signed) a
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
i
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or
materials and /or workmanship.
7,
Appacasion ;s hereby untie for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
strut uie herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and '11 provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications ipust be kept at
building during progress of work.
Owner's Name and Address
Architect and /or - - - -
Employing Plumber's Nam _ `� I� 6 ' No.____._...__.. l.L
Location and Legal Description Lot_ ._..._ Block _ _____._._.._. on
Street and Number where work is to be performed —No �__ _ _�L 7v. 1
Street ' . "
State work to be performe8 and purpose of building (By Floors) - --
New Building _____ ..__._ Remodeling___._...._.___ _._ Addition________.______. __.__. Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile._ ?.
Nature of Water Supply: ' ity —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._ _. =1_. . / v 1 Atreet
62:0L of Tank_ Capacity Gals
Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)_
(Signed)--__- -..... -____
Date
Street_
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli tions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman nt Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em ' oyed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by tlie Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. n
aster Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _..
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
ClOG6T8
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•O
POOL
CONTA.
LIST
CHECK
7,
Appacasion ;s hereby untie for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
strut uie herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and '11 provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications ipust be kept at
building during progress of work.
Owner's Name and Address
Architect and /or - - - -
Employing Plumber's Nam _ `� I� 6 ' No.____._...__.. l.L
Location and Legal Description Lot_ ._..._ Block _ _____._._.._. on
Street and Number where work is to be performed —No �__ _ _�L 7v. 1
Street ' . "
State work to be performe8 and purpose of building (By Floors) - --
New Building _____ ..__._ Remodeling___._...._.___ _._ Addition________.______. __.__. Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile._ ?.
Nature of Water Supply: ' ity —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._ _. =1_. . / v 1 Atreet
62:0L of Tank_ Capacity Gals
Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)_
(Signed)--__- -..... -____
Date
Street_
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli tions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman nt Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em ' oyed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by tlie Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. n
aster Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _..
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.